Certificate in Humanistic Integrative Counselling.
To apply for this course couldn’t be easier. simply fill in the application form below and leave the rest to us.
Application form
Which version of the course do you want?
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Please Select
Spring
Autumn
Women's only group
Name
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First Name
Last Name
Email
*
example@example.com
Address
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Street Address
Street Address Line 2
City
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Postcode
Telephone
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Gender
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Female
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Other
Pronouns
Ethnicity
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Please Select
White British
Mixed or multiple
Asian or Asian British
Black, African, Caribbean or Black British
Other
Languages
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English
Spanish
Chinese
Hindi
Arabic
Portuguese
Bengali
Russian
Japanese
French
German
Other
Date of birth
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Day
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Month
Year
Do you have a physical or sensory disability that might affect your studies and/or do you require support facilities or treatment?
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No
Yes
If you answered yes, please give more details
How did you hear about CPPD?
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Education
What is the highest level of education you have completed so far?
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Subject name
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Year of completion
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Counselling training
If applicable
Name of institution
Course title
Year of completion
Additional qualifications (if applicable)
Employment history (Current and previous employment)
Please give details of your last three jobs
Name of employer
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Position held
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Start date
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Day
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Month
Year
End date
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Day
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Month
Year
Is this your current job?
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Yes
No
If you answered no, please give a reason for leaving
Name of employer
*
Position held
*
Start date
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Day
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Month
Year
End date
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Day
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Month
Year
Reason for leaving
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Name of employer
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Position held
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Start date
*
/
Day
/
Month
Year
End date
*
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Day
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Month
Year
Reason for leaving
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Name of employer
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Position held
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Start date
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Day
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Month
Year
End date
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Day
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Month
Year
Reason for leaving
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Experience in Counselling
If you have any experience in counselling or of working in a therapeutic environment, please give a summary of details:
Reference 1
Please give a name of a reference that has known you for at least 2 years. References cannot be provided by friends or family members.
Referee name
*
Referee position
*
Referee email
*
Reference 2
Referee name
*
Referee position
*
Referee email
*
Personal statement
Please write a concise statement of between 200-400 words. This should include something about your formative personal and professional experiences and any other information that you consider will be relevant to your application. Please include your reasons for choosing the course at this time.
*
Equal opportunities
Please list any physical or sensory disabilities that might affect your studies
Do you require support facilities or additional support from CPPD?
Disclosure
Do you have any disqualifications from any professional organisations?
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Yes
No
If you answered yes, please give more details
Do you have any criminal offences, either spent or unspent?
*
Yes
No
If you answered yes, please give more details
Declaration
By ticking this box you agree to the following declaration: “I hereby declare that by submitting this form to CPPD, all of the information I have provided is, to the best of my knowledge, correct and truthful."
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Yes I agree
Name
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First Name
Last Name
Date
*
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Day
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Month
Year
Date
Please confirm your email address
example@example.com
Submit
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